How common is hypertonic pelvic floor

Hypertonic pelvic floor dysfunction is a common issue. It often goes undiagnosed, and studies show that it affects about 1 in 10 people.

Hypertonic pelvic floor symptoms

One common symptom of hypertonic pelvic floor is pain. This pain can be felt as a general discomfort or pressure around the pelvic region, lower back, or hips. It can also be specific to certain locations, such as the bladder, or occur during activities like bowel movements or sex.

Other symptoms include:

Urinary symptoms

●        Bladder pain.

●        Pain when passing urine

●        Excessive urination.

●        Struggling to maintain a urinary stream.

Bowel symptoms

●        Struggling with bowel movement (pooing).

●        Feeling like you’re unable to empty completely.

●        Pain during pooing (constipation).

●        Pain with the passing of wind.

Sexual symptoms

●        Pain during or after sexual intercourse.

●        Failing to reach orgasm.

●        Erectile dysfunction; pain with ejaculation.

Symptoms of hypertonic pelvic floor tend to develop gradually and worsen over time. It is important to discuss even mild symptoms with your GP.

What causes hypertonic pelvic floor

The causes of hypertonic pelvic floor can be complex. Certain factors can increase the risk of developing this condition, including:

1. Holding in urine or stool: Some people may develop the habit of holding in urine or stool. in  childhood if this occurs it  can continue into adulthood. Others may do so due to their lifestyle or job.
2. Injury or trauma to the pelvic muscles: Pelvic muscles can be affected by surgical procedures, pregnancy, childbirth, or traumatic accidents, leading to hypertonic pelvic floor.
3. Muscular dysfunction due to sitting, posture, or gait issues: Prolonged sitting, abnormal posture, walking with an irregular gait, or uneven pelvic bones can contribute to the development of hypertonic pelvic floor.
4. Other pain-causing conditions: Conditions like irritable bowel syndrome (IBS), endometriosis, vulvodynia, anal fissures, and painful bladder syndrome, can be associated with hypertonic pelvic floor.
5. Sexual or physical abuse: Those who have experienced sexual or physical abuse may be at a greater risk of developing hypertonic pelvic floor.
6. Stress, depression, and anxiety: Mental health factors such as stress, depression, and anxiety can also contribute to the development of this condition.
   
   

How is hypertonic pelvic floor diagnosed

When you visit your GP, they will ask about your symptoms and medical history. This includes questions about your bowel movements, urination, and sexual activity. Talking about these topics may be embarrassing or challenging, however it is important to openly discuss any problems you are experiencing. This will assist your GP in making an accurate diagnosis.

Your GP will likely conduct a physical examination, which may involve:

●        Visual inspection of your pelvic area: They will observe how well you can contract and relax your pelvic floor muscles.

●        Digital rectal exam: This examination checks the rectum and anus.

●        Pelvic exam: This exam evaluates the vagina.

Your GP may also perform additional tests such as:

●    Anorectal manometry: This test involves inserting a thin tube (catheter) with a balloon into your rectum. The balloon inflates, and the contractions and relaxations of your rectum and anus are recorded and measured using a machine.

●      Electromyography: Surface electrodes are placed on your skin to measure the electrical signals of your muscles as they contract and relax. Adhesive pads hold the electrodes in place.

●     Defecography: This test examines your bowel movements. It involves placing a special contrast substance (barium paste) into your rectum and taking X-ray pictures while you defecate on a special toilet. Bowel preparation, similar to that before a colonoscopy, is necessary to clean out your rectum and colon before the test.

●     Urodynamic tests: This is a series of tests performed together to assess your urination process and bladder function. These tests provide information on how well you pee and how your bladder works.

How is hypertonic pelvic floor treated

Physical therapy is the main treatment for hypertonic pelvic floor, aiming to retrain your muscles. Your GP will recommend a physical therapist who specialises in pelvic floor dysfunction. Physical therapists tend to recommend the following treatments for hypertonic pelvic floor:

●        Biofeedback: Teaching you how to properly contract and relax your muscles using feedback techniques.

●        Relaxation techniques: Targeting the pelvic area and abdominal wall to promote relaxation.

●        Massage, stretching, and joint movements: Employed to relieve muscle tension and enhance flexibility.

Additional treatments that your GP may suggest including:

●        Acupuncture: Using fine needles to stimulate specific points in the body for symptom management.

●        Medications: Prescribing medications to alleviate symptoms like pain, anxiety, constipation, or frequent urination.

●        Nerve stimulation: Utilising nearby nerves to address urinary or bowel incontinence.

Your GP may also involve other specialists, such as:

●        Gastroenterologist: To address constipation and evaluate pelvic floor-related issues.

●        Colorectal specialist: For pelvic floor disorders associated with bowel movements.

●        Gynaecologist: For managing reproductive health concerns in individuals assigned female at birth.

●        Urologist or urogynaecology’s: To address urinary problems or sexual dysfunction.

●        Psychotherapist: To address psychological factors related to the condition.

●        Sex therapist: For the treatment of sexual dysfunction.

How can I reduce my risk of hypertonic pelvic floor

To lower your risk of hypertonic pelvic floor, it's important to grasp the concept of contracting and relaxing your pelvic muscles. Additionally, you can take the following steps:

1. Engage in mindfulness and relaxation techniques to alleviate muscle tension.
2. Perform pelvic floor exercises during and after pregnancy to maintain muscle strength.
3. Strengthen your pelvic floor through yoga exercises.
4. Prevent constipation and avoid straining during bowel movements.
5. Seek medical attention if you experience pelvic or anal pain.
6. Seek psychological support if you have experienced trauma.
7. Avoid extended periods of holding in urine or stool.

Adopt bladder weakness pads to your underwear routine to help manage any leakages. 

3 Exercises for the hypertonic pelvic floor

Here are three exercises that you should try to lessen the symptoms of a hypertonic pelvic floor. Perform these exercises at a relaxed pace and focus on proper breathing to allow the pelvic floor to fully relax.

1. Butterfly Exercise: This exercise targets the adductor muscles. Aim to gently move your knees up and down, resembling the wings of a butterfly.
2. Squat: Engaging in squats helps reduce the tension in your pelvic floor muscles. Lower your body into a squatting position, keeping your back straight and heels on the ground.
3. Child's Pose: This pose helps open up the adductor and glute muscles. Kneel on the floor and then lower your upper body forward, stretching your arms out in front of you as you rest your forehead on the ground.

Remember, be patient with these exercises and focus on breathing correctly to maximise the relaxation of your pelvic floor muscles.

When should I get medical help

If you experience pelvic pain, difficulties urinating, discomfort during bowel movements or sex, it's important to see your GP. These symptoms often don't go away on their own, so seeking medical care is advised.

Hypertonic pelvic floor can cause uncomfortable and embarrassing symptoms such as pain and difficulties with urination, bowel movements, and sexual activity. The great news is that treatments like physical therapy can work. By talking to your GP about your symptoms as soon as possible, this will guide you to get the right treatment.

Can hypertonic pelvic floor be cured

Discussing private gynaecological problems can make people uncomfortable, embarrassed even when talking to healthcare providers or clinic staff. However, it's important to seek treatment because these issues are unlikely to go away on their own.

The good news is that most cases of overactive pelvic floor muscles can be treated successfully. By addressing the underlying muscle problems, the associated symptoms can be resolved.

How to diagnose hyperbolic pelvic floor

When seeking help for this condition, it's important to give your GP your complete medical history and be prepared to talk about your bathroom habits, sexual history, and specific symptoms. Sharing these details will help your doctor make an accurate diagnosis.

In addition, a physical examination will be done, which may include a check inside your vagina to assess the function of your pelvic floor muscles. There may also be an examination of your anus muscles called a rectal exam.

Based on the initial assessment, further tests may be needed.

Once the investigations are finished, your GP will create a plan to restore your pelvic floor to its normal state and relieve the symptoms.

How to avoid having a hypertonic pelvic floor

In summary, hypertonic pelvic floor is a condition where the muscles in the lower pelvis are constantly contracted or spasming. Its symptoms can greatly affect a person's life quality, causing pelvic pain, problems with urination and bowel movements, and sexual issues. Getting medical assistance is essential because a proper diagnosis and treatment, such as physical therapy and other interventions, can bring relief and enhance overall well-being.

FAQs

What are the options for treating hypertonic pelvic floor?

The treatment for hypertonic pelvic floor can involve pelvic floor physiotherapy, which includes techniques like manual therapy, stretching exercises, relaxation exercises, biofeedback, and learning about posture and lifestyle adjustments. In certain cases, additional interventions such as medication or counselling might be suggested.

Can lifestyle changes help with hypertonic pelvic floor?

Absolutely! Making certain lifestyle changes can be helpful in managing hypertonic pelvic floor. These changes may include practising stress reduction techniques, incorporating relaxation exercises into your daily routine, maintaining good posture, practising diaphragmatic breathing, and avoiding activities that can increase pelvic floor tension.

How long does it take to see improvement with treatment for hypertonic pelvic floor?

The time it takes to see improvement can vary from person to person. Some people may start experiencing relief of symptoms within a few weeks of beginning treatment, while others may need several months of consistent therapy. It's important to follow your GP’s advice and be patient throughout the healing process.